In the position paper in this issue [1], the American College of Physicians endorses demonstration projects for testing no-fault and enterprise liability systems. In Utah, we are about to embark on a project that incorporates elements of both concepts. As President of the Utah Medical Association, I am pleased to see the College's endorsement of such projects. As the position paper explains, the existing medical liability system is fundamentally flawed. It does not provide timely and adequate compensation to persons who sustain an injury, nor does it deter negligence. Rather, it promotes fear and mistrust, and it does not provide physicians and other health care providers with incentives to prevent and detect injuries. It also harms the physician-patient relationship and leaves physicians so vulnerable that they believe they must do procedures they would otherwise consider unnecessary.